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Embarrassing Bodies, 11:10pm Monday 1st September 2014 on More 4. Catch up for free on 4oD »

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Voiceover: Now, we’re not into ruining your holidays, but we do want to arm you with the knowledge you need to look after yourself. So, we’ve taken creepy crawlies expert Dr James Logan out of the lab and onto the beach to see if tourists can recognise one of the world’s most prolific parasites.

Dr James: What do you recon this is?

1st Holidaymaker: Maybe something from a horror movie?

2nd Holidaymaker: It looks like a vegetable. You know, like a carrot.

3rd Holidaymaker: A penis.

4th Holidaymaker: A finger.

Voiceover: This is actually a hookworm and its estimated 700,000,000 people have them living in their stomachs.

Dr James: When you get infected with them, they enter through the skin. And once they are in there, they travel in your blood through your heart to your lungs. And then you actually get a cough and cough them up into your mouth and then swallow them down to your intestine where they then attach.

5th Holidaymaker: It’s not contagious is it?

Voiceover: Hookworm larvae live both in contaminated pooh and in water droplets on the edges of leaves. And if you brush past or tread on them with your bare skin they will find a way into your body.

Dr James: The best thing you can do when you’re abroad is make sure you wear footwear, flip flops or whatever, and put your towel down when you sunbathe.

5th Holidaymaker: Ok.

Voiceover: And now here comes an experiment you definitely shouldn’t try at home. He’s at the London School of Hygiene and Tropical Medicine where Dr Quentin Bickle is helping him explain what these worms can do by infecting him with 50 hookworm larvae.

Dr James: So these actual worms are going to be inside my body.

Dr Quentin: Right.

Dr James: Right, let’s take a look. Oh wow, jeez. Right, ok, so there is loads of them there.

Voiceover: He’s taking part in a monitored scientific experiment and they’re hoping to achieve a world first by finding out exactly how the hookworm penetrate the skin and follow their incredible journey through the body. Dr Quentin Bickle and his team have lined up a special scanner that can see through the top layers of Dr Logan’s skin, before placing a water droplet containing 50 hookworm larvae onto his arm.
Dr Logan: Now, are they going to go into my skin, like, straight away or is it going to take…
Dr Quentin: Well, that’s one of the things we don’t really know so let’s just see (looks at screen). There it is.

Dr James: Here’s some over here, look.

Dr Quentin: Yeah, yeah, yeah.

Voiceover: The wriggling worms seen on the screen are still within the water droplet and Dr Logan should feel a stinging sensation when they penetrate his skin.

Dr James: Every now and again I feel a little sort of niggle on my skin. I am just wondering whether that is one going in or not.

Dr Quentin: (Examines and point to screen) It’s looks like we can only see the tail end now on the outside on the skin surface and the rest of the body is already inside of the superficial skin layer.

Dr James: Oh my goodness!

Voiceover: It’s taken just over 3 minutes for the larvae to enter Dr Logan’s body. And to get in that quickly the hookworms are probably using an enzyme to break down the skin and create a tunnel in to the blood stream.

Dr Quentin: (Pointing at screen) There is a suspicious mass.

Dr James: There is movement. There is movement there.

Dr Quentin: There is movement. It’s unusual movement.

Dr: The larvae are right there about a quarter of a millimetre into the skin.

Dr James: These worms are going to make an incredible journey through the body to the intestine. So they have got a big road ahead of them, really.

Voiceover: It will take at least seven days for the hookworms to reach Dr Logan’s intestines.

Dr James: Who wants to give me a hug? Anyone? No?

Voiceover: Once he’s left the lab, Dr Logan starts recording video diaries to explain exactly how the hookworms are affecting him as they travel through his body.

Dr James: I do have a little bit of a rash on my arm and it is a bit itchy.

Voiceover: He’s doing this so we all know what to watch out for. And the first sign is a rash where the hookworms enter the skin. Next he gets a cough as the worms are hacked up from his lungs and swallowed into his stomach.

Dr James: I have woken up to these weird stabbing pains in my stomach. If they are there, then it’s basically the adults that are attaching to my stomach. I don’t think I’m going to have a very good night’s sleep. The larvae actually enter through the skin and then travel to heart and then the lungs where they are coughed up into the throat and then they make their way down into the intestine and they stay there as adults sucking our blood.

Voiceover: It’s month two of the infection and the bloodsucking worms are unsettling Dr Logan’s stomach.

Dr James: I have got up because I have stabbing stomach pains again. I have felt sick pretty much the entire day, um, and I still feel sick.

Voiceover: After 55 days it’s time to visit a gastroenterologist at the Nuffield Health Wessex Hospital to take a closer look at what’s upsetting his guts.

Dr James: I think I probably had one of the worst night’s sleeps of my entire life last night, with horrible stabbing stomach pains, which is something that I’ve never actually felt before.

Voiceover: Dr Praful Patel can give Dr Logan a worm’s eye view of his intestines.

Dr Praful: You are going to swallow this (hold up tablet). This is a little camera in a pill.

Dr James: Right.

Dr Praful: As it goes down into the stomach and just beyond the stomach, we’re going to see the worms.

Voiceover: Special sensors designed to pick up radio signals from the camera are attached to his chest and recorded electronically.

Dr James: Here goes (swallows camera). I have a camera inside me. How strange.

Voiceover: A brief walk aids digestion. And within an hour the hookworm’s trail of destruction comes into view.

Dr Praful: You can see that red area there. This is where the hookworm has attached its head.

Dr James: Yeah, it looks pretty nasty!

Dr Praful: Although this is clear evidence of hookworm being present, we haven’t found any yet.

Dr James: They are quite difficult to find because they’re translucent.

Dr Praful: That’s right. As you can see there is quite a lot of redness here and further down. As I scroll…Oh! You can see… can you see this?

Dr James: It is, look! (Gestures to computer screen) That is definitely a worm isn’t it? And it’s full of blood as well.

Dr Praful: That’s definitely a worm.

Dr James: That’s incredible! That feels weird.

Dr Praful: It’s about a centimetre and half long.

Dr James: Yeah, and it’s really inflamed all around there. Is that another one there?

Dr Praful: Yes, there’s another one there.

Dr James: The head end is clearly up there, attached to the stomach lining with those teeth. Look how red it is around there as well. No wonder I have been having so much pain! It’s also a little bit gross.

Voiceover: Its day 60 of his infection and Dr James is back at the London School of Hygiene and Tropical Medicine to see what impact the hookworms are having on his health.

Dr Quentin: So now we are going to look at the blood that was taken from you before you were infected with this.

Dr James: Ok.

Dr Quentin: The first thing we are looking at here is a cell called an Eosinophil, it’s a very potent cell in the immune system.

Voiceover: Eosinophil blood cells are an important part of the body’s immune system which is the mechanism within us that fights infection. Eosinophils are associated with fighting parasites like hookworm. Normally they make about 1% of our blood. But people like Dr James who are infected with hookworms usually start producing more of these cells.

Dr Quentin: We can see two Eosinophils next to each other which is clearly much more abundant that we saw in the other field, just in the first field we look at.

Dr James: Oh, you can yeah. If I just move it around a bit you can see some more there as well.

Dr Quentin: So this shows the proportion of Eosinophils in your blood has now gone up 15 fold.

Dr James: 15 times more? So my entire blood in the whole of my body has changed.

Voiceover: And Dr James’s new blood could actually make him healthy. Extra Eosinophils not only fight infection, but new research suggests that they might also improve the symptoms of some allergies.

Dr James: It is quite surprising really, isn’t it, that things like asthma and irritable bowel disease can actually, essentially, be cured. Or at least the symptoms can be reduced. I suffer from some stomach problems so, certain foods I just can’t eat, it makes me very ill. So I’m really interested to find out whether doing this is going to have any effect on that.

Voiceover: Dr James hopes that his new stronger blood might be better equipped to fight an allergy he has suffered with his whole life, a food intolerance to bread.

Dr James: One thing in particular that’s guaranteed to make me feel ill is pizza and garlic bread (eats pizza) that tastes so good. I might regret it later though.

Voiceover: Normally, a pizza feast would lead to an episode of Logan’s runs, bellyache and diarrhoea. But, 18 hours later, Dr James newly strengthened immune system seems to have held out.

Dr James: I slept the entire night. I had a brilliant night’s sleep and today I feel absolutely brilliant. So, maybe the worms are actually having a good affect on my body and I’m able to eat things like bread which is great.

Voiceover: After 60 days of living with hookworm to show us their incredible journey, what symptoms to look out for and to help the medical teams understand this munching critter, Dr Logan’s finally decided it’s time to get rid of them by simply taking a tablet which can be prescribed by a doctor either when you’re abroad or when you get home.

Dr James: I have decided that the worms are going to have to go. I just can’t live with the symptoms or the stomach pains. And all I need to do is very simply, take a little pill. Well, here goes, goodbye hookworm.

Voiceover: The chemicals in the pill will kill the hookworm and clear Dr Logan’s intestines in just 3 days.

Read the video transcript

Dr James Logan decided to let hookworms burrow their way into his bloodstream, and all in the name of scientific discovery. The worms go on an amazing journey through his body, and here you can see an extended video of the experiment.

Below are some facts and figures about the microscopic hookworms that Dr Logan allowed to infest his gut.

Hookworms: A Fact File

The hookworm is an intestinal parasite. Adult worms live in the small intestine, but not before embarking on a long and complex journey.

How Do Hookworms Spread?

Hookworm eggs are passed in the poo of an infected person. If an infected person defecates outside (near bushes, in a garden, or field) or if the faeces from an infected person are used as fertiliser, eggs are deposited on soil. They then mature and hatch, releasing microscopic larvae that penetrate the skin of humans. You can pick up a hookworm infection by walking barefoot on contaminated soil or by brushing past foliage with droplets of water containing the larvae.

The Remarkable Journey of the Hookworm

Once the hookworms are inside your body, they travel in the blood through your heart to your lungs. They penetrate the lungs and travel to your throat where they are coughed up and swallowed. Once in the intestine, they mature and become adults (around 1cm long). They attach to the intestine and feed on blood.

Hookworm Symptoms

Once the worms enter the skin an itchy red rash appears. Many people have no symptoms whatsoever, but those with heavy infection may have abdominal pain, diarrhoea, loss of appetite, weight loss and anaemia. The development of children can be affected.

Risks, Prevention and Treatment of Hookworms

Do not walk barefoot in areas where hookworm is common and where there may be faecal contamination of the soil.

People living in areas with warm and moist climates and where sanitation and hygiene are poor are at risk of hookworm. High risk groups are young children.

Hookworm infections are generally treated for 1-3 days with medication prescribed by a health care provider. Iron supplements may be prescribed if you have anaemia.

The EB team would like to thank:

Dr Quentin Bickle
Research Scientist
London School of Hygiene and Tropical Medicine

Dr Daniel Woods
Michelson Diagnostics

Dr Carsten Flohr
Consultant Dermatologist
St John’s Institute of Dermatology, King’s College University of London

Dr Praful Patel
Consultant Gastroenterologist
Nuffield Health Wessex Hospital

Dr Ron Behrens
Hospital for Tropical Diseases in London

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Comments and Questions

You can share your experiences and thoughts with other Embarrassing Bodies site-users below. Comments & Questions are reviewed by moderators, but if you see anything on the site that worries you, please report it and one of our moderators will look at it as soon as possible.
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I have a parasite. The larva enters into my skin. I have itching, biting just about all over my body. They are on my privates and I can feel them crawling in my pubic hair next to my legs. It has been 9 years and now I am having problems urinating the uroligist says it is not my bladder nor kidneys. I went to a digestive specialist and he says it is my kidneys. I can not even get my family doctor to send me for tests, or a referral for an infectious specialist. She will not even look at my skin. I was put on oxygen when I first was infected with these and am still on it. I feel so tired all the time, I have to make myself move. I have been to 5 top name dermatologist. I have been treated at least four times for mites, which I do not have. I gave up going to dermatologist. They think I am crazy. My husband has them also. We were infected from contaminated mulch. I also am ashamed to go to a regular doctor also Our doctors are not trained in this, so I know even our stomach specialist think all parasites come frop]m Africa or some third world country. Dr, Lee, name changed, said I would have to have been in Africa in a big open field barefooted, to have gotten a parasite.The hookworm larva does not show up in my stool. I am at my wits end, and I know or feel like there is a blockage in my kidneys. My stomach pain is excruciating, it is in my stomach all the way across, and also in my back.I am on a lot of stomach medication and am not due another colonoscopy for 10 years. I have skin lesions on my legs, my ankles, on my feet and in my head. Can someone please help me. I also feel like I am dying.





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Why don't you try going to a health food store. The people that work there will have supplements/herbs that can be taken to rid the body of worms and parasites. Wormwood herb has been used in herbal remedies to rid the body of pinworms, roundworms, and other parasites. However, it can also be used to enhance digestion for the worm-free. Best of Luck!

Where do you live if you don't mind me asking? Most worm infections are internal. I don't understand why your doctor doesn't check further because it sounds like you may also have kidney stones because the symptoms with your bladder, pain and feeling something is stuck in your kidney sounds very familiar to kidney stones. You need to have this seriously checked out further and if these doctors refuse to believe you or help if they can or refer you to someone who can then you need to report them to the better business bureau as well as the physicians association complaint dept. your health is at risk here and as I've learned we have to be more knowledgable about our bodies, look up symptoms and even look further into anything that is confirmed to be physically wrong with us. We have to have knowledge about whatever is physically wrong or the symptoms we are experiencing. I lost my father due to negligence and there wasn't an attorney willing to go against the hospital because typically the best attorneys work for the physicians and hospitals. Had I not looked up every symptom my dad had I would of lost him sooner because the facility failed to realize there was a blood clot in my fathers arm which I knew the difference between fluid retention and why only one arm was swollen and yet the nurses and doctors ignored this when I'm in no way a physician but someone who knows that doctors and the health system can fail us and even kill us. Don't get me wrong there are excellent doctors out there but you unfortunately have to keep going weeding through the bad ones to find the best who actually listens and evaluates a person properly and is willing to follow through until he finds the problem. I wish you the best. Please don't give up there are doctors who can help you.. Have you tried a symptom checker at the mayo clinic. Com? Sometimes this can at least help you by finding what this may be or give you an idea of what you could possibly have. I wish you the best & remember persistence is a must when it comes to your health. It's ashamed we can't rely on all doctors but it's unfortunate. Best wishes. & God Bless : )

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72q3 Ray Ban 3030 0c8 2b4 2t7 m431p





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What pill was used by the man in the show to get rid of the hookworms?





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i have hookworms and been living with them 7years over the past year and half i have been having serious stomach and bowel trouble im to ashamed to go to the doctor what can i do what pill do i need please,please help me i have 2 small children and the things that are going on are serious





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I'm thinking after a year and a half of serious stomach and bowel trouble you would forget about being ashamed to go to the doctor. The doctor has seen much worse. Please go and get treated if not for you for your children's sakes.

i am john,living in athens,if u have this hookworms for log time and u dont know what will happing them and how do u do about it.thanks





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Some apparently don't know anything about hookworms, yet are very certain that they have it. From what many of you have said, I can tell assure you that you don't have hookworm. Still, you should all visit a doctor (instead of asking for help on the Internet).





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Do you need another volunteer?





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Do hookworms travel thro the body and do they make you breathless. Have had them for twelve years and have taken Vermox with no success. My doctor does not believe me as she says nothing has been found in my stool samples.Blood marks on my legs are common and often bleed down my leg.





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i have hookworms and been living with them 7years over the past year and half i have been having serious stomach and bowel trouble im to ashamed to go to the doctor what can i do what pill do i need please,please help me i have 2 small children and the things that are going on are serious





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Hi, well for quite some time I feel kicking in my stomach, the thing is I'm not pregnant. I do not sleep well and I've heard worms can attack the nervous system, so I wonder if that has been making me feel lightheaded and lethargic ( and also a nervous wreck ). I feel tired, probably due to my bad sleep patterns and my eye can occasionally jiggle. I do wonder what on earth all of this can be. It's definitely not the case of a phantom pregnancy. Tell you what, I'll look into this properly with my doc and when I know for sure what's going on, I will come back to this website-blog and let y'all know. Good luck to all finding out what their mysterious kickings are.





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It looks like no one else has asked this question, so please fill in the rest of your details below.





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